Neurological complications of immune checkpoint inhibitors: a practical guide DOI

Aisling Carr,

Frederick W. Vonberg, Shiwen Koay

et al.

Practical Neurology, Journal Year: 2024, Volume and Issue: unknown, P. pn - 004327

Published: Nov. 26, 2024

Immune checkpoint inhibition unleashes the power of immune system against tumour cells. inhibitors (ICIs) block inhibitory effects cytotoxic T-lymphocyte associated protein 4, programmed death 1, ligand 1 and lymphocyte activation gene 3 molecules on T-cells, so enhance physiological effects. ICIs can significantly improve survival from cancers, including those previously with poor treatment response, such as metastatic melanoma. However, on-target off-tumour result in immune-related adverse events. These toxicities are common require new multidisciplinary expertise to manage. ICI neurotoxicity is relatively rare but ominous due its severity, heterogenous manifestations potential for long-term disability. Neurotoxic syndromes novel often present precipitously. Here, we describe mechanisms action, their impact cancer outcomes frequency We focus particularly neurotoxicity. discuss current appreciation neurotoxic syndromes, management strategies based clinical consensus, multi-specialty guidance. The use immunotherapy expanding exponentially across multiple types too will our approach these cases.

Language: Английский

Anticancer therapy-induced peripheral neuropathy in solid tumors: diagnosis, mechanisms, and treatment strategies DOI
Jiahong Jiang, Luna Jia Zhan, Bo Jiang

et al.

Cancer Letters, Journal Year: 2025, Volume and Issue: unknown, P. 217679 - 217679

Published: March 1, 2025

Language: Английский

Citations

1
Peripheral neuropathy: from guidelines to clinical practise DOI
Berit Jordan, Franziska Jahn, Karin Jordan

et al.

Current Opinion in Oncology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 16, 2025

Purpose of review Chemotherapy-induced peripheral neuropathy (CIPN) is a substantial adverse effect anticancer therapy. No effective preventive strategies are established in clinical routine, although some forms cryotherapy or compression therapy seem to be promising. CIPN difficult grade objectively and has mostly relied on clinician- patient-based rating that subjective not easily reproducible. Recent findings preclinical studies showed an indicative hint serum neurofilaments for axonal damage as biomarker might introduced practice the future. Axonal degeneration toxic triggered by molecular pathways including SARM1. Presence certain genotypes predispose developing severe vincristine neuropathy. Still, treatment focused treating neuropathic pain primarily based physicians experience. A positive membrane stabilizers such gabapentinoids could shown systematic due inconsistent study populations. In prevention functional disability, physical exercise sensorimotor-training whole-body vibration seems Summary More research needed quantification biomarkers prior symptom expression. All these recent should support health-care team patient centred approach.

Language: Английский

Citations

0
Complications neurologiques périphériques des immunothérapies anticancéreuses DOI Creative Commons
Simon Frachet

Pratique Neurologique - FMC, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Citations

0
Prediction, prevention, and precision treatment of immune checkpoint inhibitor neurological toxicity using autoantibodies, cytokines, and microbiota DOI Creative Commons
Alberto Vogrig,

Marta Dentoni,

Irene Florean

et al.

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: March 13, 2025

Cancer immunotherapy with immune checkpoint inhibitors (ICIs) has revolutionized oncology, significantly improving survival across multiple cancer types. ICIs, such as anti-PD-1 (e.g. nivolumab, pembrolizumab), anti-PD-L1 atezolizumab, avelumab), and anti-CTLA-4 ipilimumab), enhance T cell-mediated anti-tumor responses but can also trigger immune-related adverse events (irAEs). Neurological irAEs (n-irAEs), affecting 1-3% of patients, predominantly involve the peripheral nervous system; less commonly, n-irAEs present central system disorders. Although suggest a possible correlation treatment efficacy, their mechanisms remain unclear, hypotheses ranging from antigen mimicry to cytokine dysregulation microbiome alterations. Identifying patients at risk for predicting outcome through biomarkers would be highly desirable. For example, high-risk onconeural antibodies (such anti-Hu or Ma2), elevated neurofilament light chain (NfL) levels often respond poorly irAE treatment. However, interpreting neuronal antibody tests in diagnosis requires caution: positive results must align clinical context, some (e.g., SCLC) may have asymptomatic low levels, false are common without tissue-based confirmation. Also, use IL-6) lead more targeted treatments irAEs, minimizing effects compromising efficacy ICIs. This review provides comprehensive overview latest findings on associated focus prediction, prevention, well precision using autoantibodies, cytokines, microbiota. The most interesting data concern antibodies, which we explore pathogenic roles neurotoxicity. Most available both regarding role diagnostic prognostic supporting therapeutic decisions toxicities, refer non-neurological toxicities. our review, mention potential CXCL10 CXCL13 describe current evidence, need further studies, cytokines guiding selection second-line therapies n-irAEs. Finally, no specific microbiome-related microbial signature been proven linked specifically, leading future research topic.

Language: Английский

Citations

0
Global, regional, and national burden of neuroblastoma and peripheral nervous system tumours in individuals aged over 60 from 1990 to 2021: a trend analysis of global burden of disease study DOI Creative Commons
Zihan Ding, Yun Chen,

Genbo Huang

et al.

Journal of Health Population and Nutrition, Journal Year: 2025, Volume and Issue: 44(1)

Published: March 17, 2025

Abstract Purpose Elderly individuals diagnosed with neuroblastoma and peripheral nervous system tumours often have a poor prognosis. However, there is currently lack of comprehensive analysis on these conditions in older adults. This study aims to determine the global epidemiological trends (in aged 60 above). Methods We obtained cross-sectional data from 2021 Global Burden Disease, Injuries, Risk Factors Study (GBD) ( https://vizhub.healthdata.org/gbd-results/ ). assessed burden elderly 1990 using indicators such as prevalence incidence. These were classified by global, national, regional levels, further stratified Socio-Demographic Index (SDI), age, gender. The results are organized SDI, gender categories. Results From 2021, age-standardised incidence rates among increased 0.06 (95% UI 0.05, 0.08) 0.12 0.09, 0.15) per 100,000 0.11 0.13) 0.22 0.17, 0.26) 100,000, respectively. Age-standardised mortality DALY also rose. Central Europe had highest while Eastern rate. East Asia reported number total cases experienced fastest growth, significant increases prevalence, incidence, mortality, rates. Gender disparities evident, men showing higher than women, greater EAPC values indicating increase disease over time. age-specific found 90–94 age group, 70–74 group burden. Conclusion continuous rise highlights pressing necessity for focused public health measures improved treatment approaches. Addressing regional, gender, age-related requires approach that integrates medical advancements, social support, policies. Future research should explore potential risk factors innovative therapies mitigate this growing challenge.

Language: Английский

Citations

0
The pathogenesis of neurological immune-related adverse events following immune checkpoint inhibitor therapy DOI Creative Commons
Magdalena Lerch, Sudarshini Ramanathan

Seminars in Immunology, Journal Year: 2025, Volume and Issue: 78, P. 101956 - 101956

Published: April 27, 2025

Cancer is a leading cause of morbidity and mortality worldwide. The development immune checkpoint inhibitors (ICI) has revolutionised cancer therapy, patients who were previously incurable can now have excellent responses. These therapies work by blocking inhibitory pathways, like cytotoxic T lymphocyte-associated protein 4 (CTLA-4), programmed cell death-1 (PD-1), its ligand PD-L1, lymphocyte activation gene 3 (LAG-3); which leads to increased anti-tumour However, their use lead the immune-related adverse events (irAEs), may result in severe disability, interruption even death. Neurological autoimmune sequelae occur 1-10 % treated with ICIs be fatal. They encompass broad spectrum diseases, affect central peripheral nervous system, include syndromes encephalitis, cerebellitis, neuropathy, myositis. In some cases, neurological irAEs associated autoantibodies recognising neuronal or glial targets. this review, we first describe key targets ICI followed formulation clinical presentations, where focus on syndromes. We comprehensively formulate current literature evaluating surface intracellular autoantibodies, cytokines, chemokines, leukocyte patterns, other blood derived biomarkers, immunogenetic profiles; highlight impact our understanding pathogenesis irAEs. Finally, therapeutic pathways patient outcomes, provide an overview future aspects therapy.

Language: Английский

Citations

0
Neurological complications of immune checkpoint inhibitors: a practical guide DOI

Aisling Carr,

Frederick W. Vonberg, Shiwen Koay

et al.

Practical Neurology, Journal Year: 2024, Volume and Issue: unknown, P. pn - 004327

Published: Nov. 26, 2024

Immune checkpoint inhibition unleashes the power of immune system against tumour cells. inhibitors (ICIs) block inhibitory effects cytotoxic T-lymphocyte associated protein 4, programmed death 1, ligand 1 and lymphocyte activation gene 3 molecules on T-cells, so enhance physiological effects. ICIs can significantly improve survival from cancers, including those previously with poor treatment response, such as metastatic melanoma. However, on-target off-tumour result in immune-related adverse events. These toxicities are common require new multidisciplinary expertise to manage. ICI neurotoxicity is relatively rare but ominous due its severity, heterogenous manifestations potential for long-term disability. Neurotoxic syndromes novel often present precipitously. Here, we describe mechanisms action, their impact cancer outcomes frequency We focus particularly neurotoxicity. discuss current appreciation neurotoxic syndromes, management strategies based clinical consensus, multi-specialty guidance. The use immunotherapy expanding exponentially across multiple types too will our approach these cases.

Language: Английский

Citations

1